NPI age
20 years
Enumerated 2005-07-13
● Active Type 2 · Organization
Providence Park, Inc.
Providence Park, Inc. is 1 of 3272 skilled nursing facility organizations in Texas.
Primary specialty
Skilled Nursing Facility
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Shadbolt
Ceo
Last NPPES update
2025-06-23
Source: monthly bulk 2026-05
How this organization compares
Across 3272 active skilled nursing facility providers in Texas.
NPI age
20 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 9% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-07Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
300 W Highway 6
Waco, TX 767124041
Mailing address
300 W Highway 6
Waco, TX 767124041
Authorized official
Erin Shadbolt
Ceo
📞 3147293500
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Kathleen Gainous, COTA/L Occupational Therapy Assistant NPI 1285115709
- Melissa Valerio, COTA/L Occupational Therapy Assistant NPI 1477034916
Specialties
-
Skilled Nursing Facility Primary(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness...
-
Nursing Facility/Intermediate Care FacilityAn institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 001026977 | |
| 01 | HH2907 | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 000530801 |
Other names on file (3)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Ascension Living Providence Village
-
St. Catherine Center
-
Ascension Living Providence Village
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
Provyx · Custom healthcare lists
Need all 3272 Skilled Nursing Facility providers in Texas?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.